A lay teacher-counsellor delivered brief psychological treatment for moderate to severe depression among older adolescents in senior high schools in Ghana (Y-MIND): a feasibility cluster randomized controlled trial
- 1School of Global Health, Faculty of Health, York University, Canada
Abstract
IntroductionAdolescents experience high rates of depression and anxiety, yet globally 80% of adolescents and almost all in low-and middle-income countries (LMICs) lack access to adolescent-friendly treatments. The African Youth in Mind (Y-MIND) set out to adapt the youth version of the Friendship Bench and assess its feasibility for delivery in Ghana.
MethodsIn this feasibility cluster randomised controlled trial, we recruited participants aged 15-18 years with probable diagnosis of moderate to severe depression ascertained with the Patient Health Questionnaire (PHQ-9) total score > 9 from six Senior High Schools in Navrongo, Ghana. Schools were randomly allocated (1:2) to enhanced usual care (EUC) alone or EUC combined with Y-MIND, prior to recruitment of participants. Primary outcomes were feasibility (intervention delivery; conducting a fully powered trial). Secondary outcomes were intervention appropriateness, acceptability, and probable depression symptom severity and remission on the PHQ-9.
ResultsBetween July and August 2024, we enrolled and allocated 67 participants (43 [64%] to the EUC plus Y-MIND group and 24 [36%] to the EUC alone group), of whom 64 (95.5%) completed the 5-month primary outcome assessment (41 [95.3%] in the EUC plus Y-MIND group and 23 [95.8%] in the EUC alone group). The feasibility of delivering the Y-MIND intervention from the perspective of adolescents had a mean score of 4.3 (0.5). Therapy quality score was 94.8% (95% CI: 93.0-96.6), while therapy competence was 86.6% (95% CI: 81.2-92.2). We observed initial clinical benefits, including lower severity of depressive symptoms among adolescents in the Y-MIND group as compared to those in the EUC group, with most participants achieving symptomatic remission at the month 5 follow-up.
ConclusionThe Y-MIND school-based psychological treatment model demonstrated good acceptability and feasibility, with high recruitment, retention, treatment adherence, and provider competence. While preliminary findings indicate potential improvements in depressive symptoms, the study was not designed to establish effectiveness. These findings justify progression to a fully powered trial to determine clinical effectiveness, cost-effectiveness, and the scalability of the intervention within routine school settings in LMICs. Trial registration: Clinicaltrials.gov (NCT06740084).
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BibTeX
@misc{weobong2026teachercounsellor,
title = {{A lay teacher-counsellor delivered brief psychological treatment for moderate to severe depression among older adolescents in senior high schools in Ghana (Y-MIND): a feasibility cluster randomized controlled trial}},
author = {B. Weobong and J. Hodsoll and A. G. Akanlu and K. S. Adde and D. A. Attah and J. Adagnera and T. Awine and S. Bawa and R. Jopling and B. A. Owusu and T. Bere and L. Owusu and M. Anyorikeya and P. Nyamayaro and S. Adams and F. Achana and E. Dambayi and C. Ayuure and D. J. Heller and P. B. Yaro and P. B. Adongo and F. N. Glozah and R. Aborigo and B. Barrett and P. Smith and M. Kumwenda and D. Chibanda and M. Abas and K. Goldsmith},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.08.26364988},
url = {https://www.medrxiv.org/content/10.64898/2026.10.08.26364988v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - A lay teacher-counsellor delivered brief psychological treatment for moderate to severe depression among older adolescents in senior high schools in Ghana (Y-MIND): a feasibility cluster randomized controlled trial
AU - B. Weobong
AU - J. Hodsoll
AU - A. G. Akanlu
AU - K. S. Adde
AU - D. A. Attah
AU - J. Adagnera
AU - T. Awine
AU - S. Bawa
AU - R. Jopling
AU - B. A. Owusu
AU - T. Bere
AU - L. Owusu
AU - M. Anyorikeya
AU - P. Nyamayaro
AU - S. Adams
AU - F. Achana
AU - E. Dambayi
AU - C. Ayuure
AU - D. J. Heller
AU - P. B. Yaro
AU - P. B. Adongo
AU - F. N. Glozah
AU - R. Aborigo
AU - B. Barrett
AU - P. Smith
AU - M. Kumwenda
AU - D. Chibanda
AU - M. Abas
AU - K. Goldsmith
PY - 2026
DA - 2026/10/08
PB - medRxiv
DO - 10.64898/2026.10.08.26364988
UR - https://www.medrxiv.org/content/10.64898/2026.10.08.26364988v1
AB - IntroductionAdolescents experience high rates of depression and anxiety, yet globally 80% of adolescents and almost all in low-and middle-income countries (LMICs) lack access to adolescent-friendly treatments. The African Youth in Mind (Y-MIND) set out to adapt the youth version of the Friendship Bench and assess its feasibility for delivery in Ghana. MethodsIn this feasibility cluster randomised controlled trial, we recruited participants aged 15-18 years with probable diagnosis of moderate to severe depression ascertained with the Patient Health Questionnaire (PHQ-9) total score > 9 from six Senior High Schools in Navrongo, Ghana. Schools were randomly allocated (1:2) to enhanced usual care (EUC) alone or EUC combined with Y-MIND, prior to recruitment of participants. Primary outcomes were feasibility (intervention delivery; conducting a fully powered trial). Secondary outcomes were intervention appropriateness, acceptability, and probable depression symptom severity and remission on the PHQ-9. ResultsBetween July and August 2024, we enrolled and allocated 67 participants (43 [64%] to the EUC plus Y-MIND group and 24 [36%] to the EUC alone group), of whom 64 (95.5%) completed the 5-month primary outcome assessment (41 [95.3%] in the EUC plus Y-MIND group and 23 [95.8%] in the EUC alone group). The feasibility of delivering the Y-MIND intervention from the perspective of adolescents had a mean score of 4.3 (0.5). Therapy quality score was 94.8% (95% CI: 93.0-96.6), while therapy competence was 86.6% (95% CI: 81.2-92.2). We observed initial clinical benefits, including lower severity of depressive symptoms among adolescents in the Y-MIND group as compared to those in the EUC group, with most participants achieving symptomatic remission at the month 5 follow-up. ConclusionThe Y-MIND school-based psychological treatment model demonstrated good acceptability and feasibility, with high recruitment, retention, treatment adherence, and provider competence. While preliminary findings indicate potential improvements in depressive symptoms, the study was not designed to establish effectiveness. These findings justify progression to a fully powered trial to determine clinical effectiveness, cost-effectiveness, and the scalability of the intervention within routine school settings in LMICs. Trial registration: Clinicaltrials.gov (NCT06740084).
ER -